Clinical characteristics and one-year survival in heart failure patients more than 85 years of age compared with younger

被引:23
作者
Conde-Martel, Alicia [1 ]
Formiga, Francesc [2 ]
Perez-Bocanegra, Carmen [3 ]
Armengou-Arxe, Arola [4 ]
Muela-Molinero, Alberto [5 ]
Sanchez-Sanchez, Cristina [6 ]
Diez-Manglano, Jesus [7 ]
Montero-Perez-Barquero, Manuel [8 ]
机构
[1] Univ Hosp Gran Canaria Dr Negrin, Internal Med Serv, Las Palmas Gran Canaria 35010, Spain
[2] Univ Hosp Bellvitge, Internal Med Serv, Barcelona, Spain
[3] Univ Hosp Vall dHebron, Internal Med Serv, Barcelona, Spain
[4] Hosp Girona Josep Trueta, Internal Med Serv, Girona, Spain
[5] Hosp Monte San Isidro, Internal Med Serv, Leon, Spain
[6] Hosp Nuestra Senora Sonsoles, Internal Med Serv, Avila, Spain
[7] Hosp Royo Villanova, Internal Med Serv, Zaragoza, Spain
[8] Univ Hosp Reina Sofia, Internal Med Serv, Cordoba, Spain
关键词
Heart failure; Very elderly; Prognosis; Comorbidity; Functional status; LONG-TERM MORTALITY; ELDERLY-PATIENTS; NUTRITIONAL-STATUS; INDEX; PREDICTORS; MANAGEMENT; ADMISSION; OUTCOMES; EPIDEMIC; PARADOX;
D O I
10.1016/j.ejim.2013.01.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Heart failure (HF) is frequent in elderly patients, but few studies have focused on patients older than 84 years. The aim of this study was to evaluate major comorbidities and 1-year survival in HF patients aged >= 85 years compared with younger age groups. Methods: Patients included in a prospective national registry of HF (RICA) were evaluated. Sociodemographic data, Charlson comorbidity index, cognitive status, basal functional status, body mass index, NYHA functional class, and left ventricle ejection fraction (LVEF) were recorded. Patients aged >= 85 years were compared with the rest using the Cox regression model to detect independent predictive factors of 1-year survival. Results: Of the 1172 patients included, 224 (19%) were aged over 84 years-old, mostly women, with hypertensive heart disease (46%, p<0.001) and preserved LVEF (68.7%; p<0.001). Diabetes (p<0.001), dyslipidemia (p=0.03) and obesity (p<0.001) were less prevalent in this group of patients. One-year mortality in the oldest old patients was 26.3%, which was higher than the rest (p<0.001). By multivariable analysis, a higher NYHA functional class (p=0.038), anemia (p=0.037), absence of obesity (p=0.002), and a worse functional status (p=0.049) were related to a worse 1-year survival in the oldest HF patients. Conclusions: The oldest old HF patients have differential characteristics with lower prevalence of diabetes, dyslipidemia and obesity and a lower 1-year survival. Independent factors related to a worse 1-year survival in the oldest age group were a higher NYHA class, a worse functional status, presence of anemia and absence of obesity. (C) 2013 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
引用
收藏
页码:339 / 345
页数:7
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